Conceptual Framework Public Mental Healthcare Work in development Conceptual Framework Working Party

10/7/20152 Why do we need a conceptual framework for public mental healthcare? Demarcation of public mental healthcare and determining the User focus Shared vision of vulnerability and social exclusion - design shared language Promote synthesis of knowledge within the same framework & concepts International match & profiling

Task public mental healthcare 10/7/20153 Defensive: Early detection and influencing of risk factors and protective factors with a view to preventing and reducing exclusion and homelessness and to generating an acceptable quality of life for vulnerable people. (Wolf, 2006) Attacking: To support socially vulnerable people in their recovery process on their way to becoming fully-participating citizens in society and towards achieving the quality of life they desire. (Wolf, 2009)

Public mental healthcare ladder target groups, functions and setting Rungs on public mental healthcare ladder Target groupPublic mental healthcare functions Setting 0,1Risk groupsPrevention functionThe community 2Vulnerable in the community Safety net and reintegration function The community 3Vulnerable in institutions Asylum and transition function The facility 4Vulnerable on the street Support functionThe street 10/7/20154  J. Wolf 2006

Public mental healthcare: Public responsibility CollectiveIndividual and/in system USER FOCUS Target group (Sub-groups in) PopulationIndividuals/systems lack of minimum necessities of life and/or; threat to safety & freedom TaskMaintain and improve physical and mental health & tackle risk factors Ensure: minimum quality of life access to entitlements & care safety support recuperation process public mental healthcare intervention Collective prevention: Detection and (early) intervention Emergency care, support, care and reintegration 10/7/20155

Society Institutions Social cohesion Social empowerment Quality of life Social inclusion Socioeconomic security Community Individual Social Quality Model

Society Institutions Social cohesion Social empowerment Quality of life Social inclusion Socioeconomic security Community Individual Social Quality Model State of social exclusion Lack of participation: social and cultural/normative Material deprivation Lack of access to social entitlements & care Lack of future prospects

10/7/20158 Self-reliance and self-control Interaction between: Skills and abilities of individual/household Demands and support from environment Partly determined by: Hope and focus on target - give sense of purpose Material and immaterial sources Self-esteem & identity Degree of access to institutions

Take responsibility: rights, but also obligations CollectiveIndividual CitizenshipReciprocity: direct and be directed Reciprocity: contribute to and participate in RightsSafeguard social entitlements No abuse of entitlements or public resources Safety and freedomGuarantee safety and freedom, whilst protecting public and individual interests Right of self- determination while respecting public interests Shared standards and values Solidarity while respecting pluriformity Loyalty to community and institutions 10/7/20159

Society Institutions Social cohesion Social empowerment Quality of life Social inclusion Socioeconomic security Community Individual Social Quality Model Intervention domains: conditions for participation Necessities of life: Income, housing, work/daily activities, education, safety, etc. Social embedding Trust in others Respect for autonomy Positive relationships Shared values, standards & identities Healthy living environment Health & behaviour: Self-control Self-confidence Skills Cognitive abilities Resilience Institutional embedding: Trust in institutions Access to care & institutions Access to information & rights  J. Wolf 2008